Organization
PAN AM DENTAL LP
Active
Organization
PAN AM DENTAL LP
Active
Other names
Dental Office
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BARBARA MATA (OFFICE MANAGER)
(210) 342-2000
Entity
Organization
Contact information
Practice address
600 DIVISION AVE, SUITE A, SAN ANTONIO, TX 78214-1350
(210) 342-2000
(210) 342-2517
Mailing address
8261 FREDERICKSBURG RD, SAN ANTONIO, TX 78229-3357
(210) 924-7277
(210) 922-5199
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
20173
TX
261Q00000X
Clinic/Center
20176
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155832201
—
TX
Enumeration date
03/27/2007
Last updated
04/25/2012
Update your record
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